Stereotactic and functional neurosurgery · 2015
The Influence of Bilateral Subthalamic Nucleus Deep Brain Stimulation on Impulsivity and Prepulse Inhibition in Parkinson's Disease Patients.
Клиническое исследованиеСтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Gee Lucy, Smith Heather, De La Cruz Priscilla, Campbell Joannalee, Fama Chris, Haller Jessica, Ramirez-Zamora Adolfo, Durphy Jennifer, Hanspal Era, Molho Eric, Barba Anne, Shin Damian, Pilitsis Julie G
Аннотация
BACKGROUND: At least 14% of Parkinson disease (PD) patients develop impulse control disorders (ICDs). The pathophysiology behind these behaviors and the impact of deep brain stimulation in a real-life setting remain unclear.
OBJECTIVES: We prospectively examined the impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on ICDs in PD patients, as well as the relationship between impaired sensorimotor gaiting and impulsivity.
METHODS: Patients undergoing bilateral STN-DBS were assessed for ICDs preoperatively and 1-year postoperatively using a validated questionnaire (QUIP-RS). A subset of patients completed the Balloon Analogue Risk Task (BART) and auditory prepulse inhibition (PPI) testing.
RESULTS: Analysis revealed 12 patients had an improvement in score assessing ICDs ('good responders'; p = 0.006) while 4 had a worse or stable score ('poor responders'; p > 0.05). Good responders further exemplified a significant decrease in hypersexual behavior (p = 0.005) and binge eating (p = 0.01). Impaired PPI responses also significantly correlated with impulsivity in BART (r = -0.72, p = 0.044).
DISCUSSION: Following bilateral STN-DBS, 75% of our cohort had a reduction in ICDs, thus suggesting deep brain stimulation effectively manages ICDs in PD. The role of impaired PPI in predisposition to ICDs in PD warrants further investigation.
OBJECTIVES: We prospectively examined the impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on ICDs in PD patients, as well as the relationship between impaired sensorimotor gaiting and impulsivity.
METHODS: Patients undergoing bilateral STN-DBS were assessed for ICDs preoperatively and 1-year postoperatively using a validated questionnaire (QUIP-RS). A subset of patients completed the Balloon Analogue Risk Task (BART) and auditory prepulse inhibition (PPI) testing.
RESULTS: Analysis revealed 12 patients had an improvement in score assessing ICDs ('good responders'; p = 0.006) while 4 had a worse or stable score ('poor responders'; p > 0.05). Good responders further exemplified a significant decrease in hypersexual behavior (p = 0.005) and binge eating (p = 0.01). Impaired PPI responses also significantly correlated with impulsivity in BART (r = -0.72, p = 0.044).
DISCUSSION: Following bilateral STN-DBS, 75% of our cohort had a reduction in ICDs, thus suggesting deep brain stimulation effectively manages ICDs in PD. The role of impaired PPI in predisposition to ICDs in PD warrants further investigation.
Предметные рубрики MeSH
AdultAgedAntiparkinson AgentsCombined Modality TherapyDeep Brain StimulationDisease SusceptibilityDisruptive, Impulse Control, and Conduct DisordersFemaleFollow-Up StudiesHumansImpulsive BehaviorMaleMiddle AgedParkinson DiseasePrepulse InhibitionProspective StudiesSeverity of Illness IndexSurveys and Questionnaires